Quizzes 65

is a software used by Anthem to provide code editing.

Using SCCF# 10220220833022700 in BlueSquared,Why was this claim adjusted?

• . Void due to duplicate claim received

• Void and rekey to correct the patient information

• Void and rekey to correct the provider information

Common Rekey Reasons

• • Incorrectly keyed in from front-end vendor

  • Incorrect provider number used

• • Incorrect member number used
  • Processed claims with action code R00000

• • Paid claims
  • Open DF Message code

is an external vendor that provides claim editing

Void/Cancel of Prior Claim

WGS

Requires the Member’s Home Plan to respond.

A provision by which the member is responsible for paying a minimal dollar amount at the time a service is rendered.

• Deductible

• Copay

• Coinsurance

Common validations and edits shared by all Plans

Did the claim denied correctly? 2022280EN0901.

• Yes

• No

• Maybe